Since the crisis, the health sector has suffered from a lack of strategic leadership. From 2009 to 2014, there were four Ministers of Health appointed, The objectives of the National Health Strategy, which ended in 2011, was informally extended with no interim strategy put in place. This resulted in a general loss of direction in the sector and fragmentation of coordination and funding among partners. In the first year after the elections and the placement of the new Government, the Ministry of Health went through a period of transition. In March 2014, the Prime Minister was also appointed the Minister of Health. In that past year, some key developments have taken place including the launch of the development of the new health sector strategy and the revitalization of the International Health Partnership in Madagascar. As of March 2015, a new Minster of Health and Secretary General of the MOH have been appointed with the key objectives of re-instilling strategic direction in the sector. The new Health Sector Strategy (2015-2019) is awaiting final Government validation. There are six strategic axes and the estimated budget needed when prioritizing maternal and child health interventions is estimated to be US$1.4 billion over the next five years. The Ministry has also explicitly committed to a the development of a Universal Coverage Strategy by the end calendar year 2015 with the first mission already having taken place. There are important challenges in the overall budget envelope and the coordination of financing (much of it being external financing) which should be addressed as they are key drivers to the success of the implementation these strategies.